Malangizo ntchito mankhwala a shuga Farmiga, zikuchokera, kagwiritsidwe, ntchito mawonekedwe, kumasula, ndemanga, ndemanga
Ndi matenda amtundu wa 2 shuga, kapamba amasokonezeka, chiwopsezo cha minofu ya m'thupi chimayamba kuchepa. Matenda ofananawo nthawi zambiri amapezeka mwa anthu opitirira zaka 45.
Chithandizo cha matendawa chimakhala ngati mumwa mankhwala a hypoglycemic, ndipo adotolo amakupatsaninso mankhwala ena othandizira komanso masewera olimbitsa thupi. Choyamba odwala matenda ashuga ayenera kusinkhasinkhanso moyo wanu, kusintha zakudya zamagulu onse ndikuwonjezera ntchito zamagalimoto.
Kuti muwonetsetse kuti kuchuluka kwa shuga m'magazi ndikwabwinobwino, mapiritsi omwe amachepetsa shuga m'magazi amatsimikiziridwa. Mankhwala amabwezeretsa kukhudzika kwa minyewa kupita ku mahomoni, amachepetsa kuyamwa kwa insulin m'matumbo, amachepetsa kupanga shuga m'maselo a chiwindi, komanso amachepetsa cholesterol.
Kuchepetsa Matendawa
Mankhwala onse ochizira matenda amhuga a 2 amatha kugawidwa m'magulu angapo molingana ndi zomwe akuchita. Izi zikuphatikiza ndi Biguanides, zotumphukira za sulfanylurea, ma insretin, alpha-glucosidase inhibitors, zotumphukira za thiazolidinone, dipeptidyl peptidiase 4 inhibitors, GLP-1 receptor agonists.
Biguanides amachititsa maselo otumphuka kuti azitha kutengeka ndi insulin, amachepetsa kupanga kwa mahomoni, komanso amachititsa kuti azikhala ndi chidwi chofuna kudya. Izi zikuphatikiza mapiritsi a Siofor ndi Metformin. Mankhwala, odwala matenda ashuga amachepetsa kulemera, zamadzimadzi metabolism amakhala. Mankhwalawa nthawi zambiri amayambitsa kugwiritsidwa ntchito kwa mawonekedwe a kupukusa chakudya, kotero, mankhwalawa amatengedwa muyezo wochepa pokhapokha atakambirana ndi adokotala.
Nthawi zambiri, mtundu wachiwiri wa matenda a shuga umagwiritsidwa ntchito ndi zotumphukira za sulufayidi - Chlorpropamide, Starlix, Glimepiride, Tolbutamide, Diabeteson. Mankhwalawa amalimbikitsa kupangidwa kwa mahomoni ndi maselo a kapamba ndipo amachepetsa chiwopsezo cha minyewa kupita ku insulin. Mankhwala oterowo amatha kufooketsa kapamba, ngati mulingo wambiri umalakwika, umayambitsa hypoglycemia.
- Mankhwala Insulinotropic polyptipid ndi Enteroglucagon amasiyana pamaso pa ma impretins - mahomoni am'mimba ochita kupanga, omwe amapanga zomwe zimachitika munthu atatha kudya. Ma mahormonewa amapangitsa kuti insulini ipange. Ndi zaka, katundu wa maselo amachepetsa m'munthu, amapangira mankhwala kuti abwezeretsenso ntchitoyi.
- Ma alpha-glucosidase inhibitors samalola kuti ma carbohydrate azilowetsedwa m'matumbo ang'onoang'ono, omwe amachepetsa glycemia atatha kudya ndikuchepetsa kufunika kwa kupanga kwa insulin. Glucobai, Miglitol, Acarbose, mapiritsi a Voglibosis amalembedwa ngati mankhwala owonjezera.
- Chifukwa cha zotumphukira za thiazolidinone, kukana kwa insulin zolandila kumachuluka, shuga m'magazi amachepetsa, metabolidi ya lipid imabwezeretseka, kuchoka kwa glucose ochulukirapo m'thupi kumachitika mofulumira. Mafuta a cholesterol okwera kwambiri komanso otsika amawonjezekanso. Odziwika kwambiri ndi mankhwala a pioglitazone ndi Rosiglitazone. Gulu la mankhwalawa limayambitsa mavuto ambiri komanso limawonjezera thupi.
- Kuonjezera kuyankha kwa ma kapamba a shuga, shuga m'munsi mwa glycated ndi triglycerides m'magazi, chithandizo ndi zoletsa za dipeptidyl peptidiasis 4 Mothandizidwa ndi Sitagliptin, Vildagliptin, wodwala matenda ashuga amatha kuyang'anira glycemia.Mankhwala amatengedwa onse palokha komanso mogwirizana ndi Metformin.
- Kuti muthane ndi chilakolako cha kudya, dokotala angakupatseni wodwala matenda ashuga kuti atenge GLP-1 receptor agonists. Mankhwalawa amakhazikika thupi msanga komanso samalola kudya kwambiri. Chifukwa cha izi, kulemera kwa wodwala kumachepa ndipo mawonekedwe a glycemic amakhala osasinthika. Mankhwala a gululi akuphatikiza mayankho a jakisoni wa Viktoz ndi Baeta, mtengo wawo ndiwokwera kwambiri ndipo umafika ku ruble 10,000.
Malinga ndi lingaliro la kuchitapo kanthu, mankhwalawa amatha kugawidwa m'magulu atatu: Mankhwala omwe amakhudza zisumbu za Langerhans ndi kapamba kuti amalimbikitse kuphatikiza kwa insulin, mankhwala omwe amalimbikitsa mphamvu ya mahomoni pa shuga ndi shuga yotsitsa shuga zomwe zimakhudza kuchuluka kwa kuyamwa kwa shuga.
Kutulutsa Fomu
"Farmiga" siipangidwa, chifukwa ilibe.
"Nateglinide" imapezeka mu mapiritsi a 60 mg ndi 120 mg. Wothandizirayu amatha kugwiritsidwa ntchito ku monotherapy kapena kuphatikiza ndi metformin ya matenda a shuga a 2. Ku United States, zikuwonetsedweratu kuti odwala matenda ashuga omwe salabadira sulfonylurea sayenera kuthandizidwa ndi nateglinide. Momwemonso, kuphatikiza ndi sulfonylurea kumapangidwa.
Izi zidapangidwa ndi kampani yaku Japan ya Ajinomoto. Ku United States ndi ku Europe (kuphatikiza Netherlands), amagulitsidwa kwa Novartis pansi pa dzina la Starlix mtundu wa mapiritsi amkamwa.
Pharmacodynamics ndi pharmacokinetics
Mwapangidwe nateglinide ndimachokera ku phenylalanine. Ma glinides amawonjezera katulutsidwe ka insulin m'maselo a beta. Nateglinide imayambitsa kuwonjezeka msanga kwa kaphatikizidwe ndi kutulutsidwa kwa insulin, zotsatira zake za insulin zotulutsira zimafikira pakatha ola limodzi ndipo zimatha maola atatu mpaka anayi. Mu kafukufuku wina, m'maphunziro 15 athanzi, nateglinide (mlingo umodzi) adachita zinthu mwamphamvu, koma yayifupi, kuposa repaglinide (2 mg).
Kuzungulira kwa plasma kwakukulu kumayesedwa pafupifupi ola limodzi mutatha kutenga nateglinide. Bioavailability akuyerekeza 73%. Gawo loyamba lakuwonongeka limachitika m'chiwindi kudzera mu dongosolo la cytochrome P450: mpaka 70% kudzera mwa isoform ya CYP2C9, mpaka 30% kudzera CYP3A4. Mwa mitundu 9 yodziwika ya metabolites, pali ena omwe amagwira ntchito pamankhwala, koma akuwoneka kuti sawonjezera mphamvu yonse. Hafu ya moyo wa nateglinide plasma ili pafupifupi maola 1.5. Mwa anthu omwe ali ndi vuto lochepa kwambiri la hepatic, milingo ya plasma yokwezeka pang'ono inayezedwa.
Zizindikiro ndi contraindication
M'mayesero azachipatala, nateglinide idaphunziridwa mwa anthu pafupifupi 2,400 omwe ali ndi matenda osokoneza bongo omwe amadalira insulin, theka la iwo adagwiritsa ntchito mankhwalawa kwa miyezi isanu ndi umodzi. Pakufufuza kwamaso kawiri, nateglinide idafaniziridwa ndi mankhwala onse a placebo ndi ena apakamwa. Maphunziro angapo adasindikizidwa kwathunthu. Nateglinide nthawi zambiri amapatsidwa katatu patsiku.
Hypoglycemic zotsatira za nateglinide zalembedwa ndi maphunziro angapo olamulidwa ndi placebo. Anthu 289 adalandira chithandizo kwa masabata 12 ndi placebo kapena imodzi mwa mitundu inayi ya nateglinide. Ndi nateglinide, hemoglobin ya glycated idatsika ndi 0,5%, ndipo kuthamanga kwa magazi a m'magazi amatsika ndi 4 mfundo. Zotsatira za nateglinide zimadalira mlingo. The pazipita zimawonedwa pa mlingo wa 180 mg.
Pakafukufuku wina wamaso awiri wama 701, magulu anayi adakhazikitsidwa: woyamba adalandira placebo, wachiwiri nateglinide, wachitatu metformin, ndipo wachinayi kuphatikiza kwa nateglinide ndi metformin. Pambuyo pa masabata 24, HbA1c komanso kuchuluka kwa glucose m'magazi mwa odwala omwe akutenga nateglinide adachepa kwambiri. Muzochitika zonse, kusiyana pakati pa magulu pawokha kunali kwakukulu.
Mu kafukufuku wina, nateglinide ndiyothandiza kwambiri kuposa glibenclamide. Ngakhale kuyerekezera ndi "glitazone" kunawonetsa kuti nateglinide imachita zoyipa, chifukwa chake, sikulimbikitsidwa kwa odwala matenda ashuga.
Nateglinide sayenera kugwiritsidwa ntchito ngati hypersensitivity ya mankhwalawa komanso odwala matenda a shuga a insulin amadalira. Zomwezi zimagwiranso ntchito kwa odwala matenda a shuga - odwala matenda ashuga komanso kuwonda kwambiri kwa chiwindi.
Chiwopsezo chachipatala ndi kuwunika kwa mapindu kuyenera kuchitidwa mwa odwala omwe ali ndi chiwindi cholimba. Odwala omwe ali ndi dialysis, kusintha kwa mlingo kungafunike. Zomwezi zimagwiranso ntchito pantchito yaimpso, komanso odwala ofooka.
Mwa odwala omwe ali ndi zaka zopitilira 75, mphamvu ndi chitetezo cha nateglinide sizinaphunzire. Chifukwa chake, ndikofunikira kuyeserera koopsa pa zaumoyo.
Nateglinide sikulimbikitsidwa kuti mugwiritse ntchito pa nthawi ya pakati kapena poyamwitsa. Kuyesa kwanyama kwawonetsa zotsatira zoyipa kwa mwana wosabadwa. Kuphatikiza apo, sizikudziwika ngati chinthu chogwira chimadutsa mkaka wa m'mawere. Mankhwala sakusonyezedwa kuchitira ana ndi achinyamata ochepera zaka 18.
Zotsatira zoyipa
Mu 2-3% ya odwala pamavuto azachipatala, hypoglycemia yayikulu idachitika (shuga m'magazi pansi pa 3.3 mmol / L). Odwala ena anali ndi zizindikiro za m'mimba kapena chimfine, koma zizindikirozi sizinali zachilendo kwambiri kuposa ndi placebo. Nthawi zina, kuwonjezeka kwa michere ya chiwindi kwachitika. Komabe, kafukufuku wina adanena kuwonjezeka pang'ono kwa kulemera poyerekeza ndi placebo ndi metformin.
Zotsatira zoyipa:
- Zotsatira zazikulu zam'madzi,
- Vertigo syndrome
- Kutentha
- Zotsatira
- Kuchulukitsa chilakolako
- Kuchepetsa mseru
- Kutopa
- Zofooka
- Matenda opatsirana a thirakiti.
Zotsatira zoyipa:
- Hypersensitivity zimachitika,
- Kuchuluka kwa chiwindi michere.
Zotsatira zoyipa zomwe zimachitika kawirikawiri:
Mlingo ndi bongo
Mulingo wamba wa nateglinide ndi 360 mg tsiku lililonse. Piritsi imatengedwa musanadye, mphindi 30 pambuyo pake imalimbikitsidwa kudya. Kuchepetsa chiopsezo cha hypoglycemia, thunthu liyenera kugwiritsidwa ntchito limodzi ndi chakudya. Mankhwala ayenera kugwiritsidwa ntchito mosamala pakulimbitsa kwambiri hepatopathy. Gwiritsani ntchito amayi apakati komanso oyembekezera, ana, ndi achinyamata ayenera kupewedwa.
Kuchita
Mankhwalawa amaphatikizidwa kwambiri ndi CYP2C9 ndipo, pang'ono, CYP3A4. Kuphatikiza kwa CYP2C9 inhibitor, monga sulfinpyrazone kapena fluconazole, kumawonjezera kuyikika kwa plasma. Kuphatikiza apo, mankhwala ambiri amakhudza shuga.
- Hypoglycemia iyenera kupewedwa.
- Pa chithandizo, mayeso azachipatala pafupipafupi amafunikira.
- Zotsatira zama psychomotor zimatha kusokonekera kwambiri. Chifukwa chake, odwala saloledwa kuyendetsa magalimoto.
Zofanizira zazikulu (zolowa m'malo):
| Dzina la mankhwala (m'malo mwake) | Zogwira ntchito | Zolemba malire achire zotsatira | Mtengo pa paketi iliyonse, pakani. |
| Bayeta | Exenatide | Maola 2-5 | 4766 |
| "Liraglutid" | Liraglutide | Maola 4-6 | 5000 |
Maganizo a munthu wodwala matenda ashuga komanso wodziwa bwino.
"Farmiga" ndi mankhwala onyenga omwe kulibe. Masamba achinyengo amabwera ndi mayina ndi mankhwalawa kuti apindule ndi nzika zachinyengo. Odwala amalangizidwa kupewa mawebusayiti ngati amenewa.
Slava Aleksandrovich, katswiri wa matenda ashuga
Ndinayesa kupeza zambiri pa intaneti zokhudzana ndi mankhwalawa "Farmiga", koma ndidazindikira kuti sizipezeka. Achinyengo amabwera ndi dzina, ndipo sanadandaule kufotokoza momwe amapangidwira "njira zozizwitsa." Ndikupangira kupewa kupewa zipsera zotere komanso osalipira ndalama za "ndalama".
Mtengo (mu Russian Federation)
Mankhwala okhazikitsidwa katatu patsiku amatenga ma ruble 3000. Mtengo wa repaglinide pamwezi ndi wochokera ku 700 mpaka 2000 rubles aku Russia. Mankhwala ochiritsira am'kamwa otchipa amakhala otsika mtengo kwambiri: ngakhale mulingo waukulu, glibenclamide imakhala yotsika 500 ruble. Metformin ndi yotsika mtengo kwambiri ndipo imawononga ma ruble 100 paphukusi lililonse.
Uphungu! Musanagwiritse ntchito, funsani kwa dokotala. Nateglinide ndi okhazikitsidwa ndi dokotala. Odwala omwe amayesera kuyitanitsa Farmiga nthawi zambiri sanalandire katundu. Ndikulimbikitsidwa kusamala ndi zinthu zachinyengo.
Subetta - malangizo, gwiritsani ntchito, mtengo, ndemanga
Subetta amatanthauza othandizira a hypoglycemic. Amagwiritsidwa ntchito makamaka pa zovuta kuchiza matenda a shuga mwa odwala omwe ali ndi insulin yambiri.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapangidwa mwa mawonekedwe a lozenges. Ndi osalala, oyera, oyera. Pali mzere wogawa mbali imodzi. M'matumba am'manja muli mapiritsi 20. Mu katoni mukhonza kukhala 1 mpaka 5 mapaketi ndi malangizo ogwiritsira ntchito.
Piritsi 1 ili ndi 0,006 g yogwira mankhwala. Othandizira ndi: magnesium stearate, isomalt, crospovidone.
Zotsatira za pharmacological
Wothandizila wovuta ndi hypoglycemic effect. Amapangidwa kuti athandize odwala matenda ashuga ndi chitukuko cha thupi kukana insulin. Mankhwalawa ali ndi synergism pokhudzana ndi maselo a insulin omwe amatha kuzindikira. Nthawi yomweyo, mphamvu ya mankhwala a insulin imakulirakulira, ndipo chiwopsezo cha zovuta zimachepa.
Imagonjera machitidwe a allosteric modulation (ma antibodies) amayamba kulimbikitsa chidwi cha insulin receptors. Chifukwa chake, kumva chidwi ndi zigawo zikuluzikulu kumabweretsa mphamvu yogwira ya shuga.
Mukamagwiritsa ntchito mankhwalawa, mitsempha ya mtima imachepa. Chiwopsezo chokhala ndi ma spasms a mitsempha ya mtima imachepetsedwa, zizindikiro za kuthamanga kwa magazi zimasinthidwa. Uku ndiye kukhudzidwa kwa mankhwalawa.
Mukamagwiritsa ntchito mankhwalawa, mitsempha ya mtima imachepa.
Ma antibodies amawonjezera amathandizira pakukonzekera kwa antiasthenic, anti-nkhawa zotsatira, kuwonjezera, kukhazikika kwa magwiridwe antchito a dongosolo lodziyimira pawokha. Chiwopsezo cha zovuta za matenda a shuga mu mawonekedwe a mtima, ma neuropathies ndi nephropathies amachepetsa kwambiri.
Ndi chisamaliro
Chenjezo liyenera kumwedwa mwa anthu okalamba ndi ana. Mwa ana, chitetezo chokwanira chimakhala chofooka, osapangidwa kwathunthu. Ma antibodies samapangidwa mwachangu, kotero, mankhwalawa amadzipatsa muyezo wochepetsetsa komanso kungokhala bwino munthawi ya chithandizo chachikulu.
Subetta imalembedwa kwa odwala omwe ali ndi matenda a shuga, momwe insulin imatchulidwira.
Okalamba ali ndi chiopsezo chachikulu cha mtima ndi mtima. Ngati zizindikiro zonse zaumoyo zikusintha, mankhwalawo amachotsedwa.
Chenjezo liyeneranso kuchitidwa pamaso pa mbiri ya matenda a impso ndi chiwindi. Pankhaniyi, muyenera kusintha mlingo wotsatira kuchuluka kwa thanzi la munthu.
Ndi matenda ashuga
Mlingo wa mankhwalawa zimatengera kuuma kwa matenda, ndipo mwa ana, kulemera kwa thupi kumathandizidwanso. Ngati palibe zotsutsana ndi zoyipa, tikulimbikitsidwa kuti mutenge piritsi limodzi katatu pa tsiku. Chiwerengero cha mapiritsi patsiku chimadalira kuchuluka kwa chiphuphu chaz shuga ndipo chimakhazikitsidwa payekhapayekha kwa wodwala aliyense.
Gwiritsani ntchito pa nthawi yoyembekezera
Palibe njira yodalirika kuti mankhwalawa adutsa chotchinga ndi kulowa mkaka wa m'mawere. Chifukwa chake, mapiritsi amayikidwa pokhapokha ngati phindu kwa mayi lidzapambana zomwe zingavulaze mwana wosabadwayo.
Subetta simalimbikitsidwa kwa ana ochepera zaka zitatu.
Kuwoneka kwa zizindikiro za bongo kumatheka pokhapokha ngati wodwala mwangozi amatenga mapiritsi angapo nthawi.
Panthawi imeneyi, maonekedwe a mseru komanso kusanza, kutsegula m'mimba, komanso zovuta zina zam'mimba.
Chifukwa cha kutchulidwa kwakukulu, kutenga mapiritsi angapo a Subetta nthawi imodzi kumatha kupangitsa kuti magazi achepe kwambiri, omwe ndi owopsa kwa okalamba.
Kuyenderana ndi mowa
Simungathe kuphatikiza zakumwa zoledzeretsa ndi zakumwa zoledzeretsa. Ndi kuphatikiza uku, zizindikiro za kuledzera zimatha, ndipo mphamvu yogwiritsa ntchito mankhwalawa imachepa.
Subetta ilibe fanizo pazomwe zimagwira. Pali malo okhawo omwe amathandizira mankhwalawa omwe ali ndi vuto lofanana la hypoglycemic.
Sikulimbikitsidwa kumwa mapiritsi ndi mankhwala ena kuti muchepetse matenda a shuga.
Tsiku lotha ntchito
Ndi zaka 3 kuyambira tsiku lopangira, zomwe zikuyenera kuwonetsedwa pazomwe zimapangidwira koyambirira.
Kuwoneka kwa zizindikiro za bongo kumatheka pokhapokha ngati wodwala mwangozi amatenga mapiritsi angapo nthawi.
Kampani yopanga: LLC NPF Materia Medica Holding.
Ndemanga za Subetta
Popeza mankhwalawa amagwiritsidwa ntchito kwambiri ndi magulu osiyanasiyana a odwala, mutha kupeza ndemanga zambiri za izi, osasiyidwa ndi akatswiri okha, komanso ndi odwala. Kuphatikiza apo, mankhwalawa amathandizira kuchepetsa thupi ndikuwonetsetsa kuti ali pamlingo woyenera mwa kuchepetsa shuga.
Roman, wazaka 47, wazachipatala, ku St. Petersburg: “Nthawi zambiri ndimapereka mankhwala kwa odwala anga. Kusakhutira ndi zomwe anachita machitidwe anga sizinali. Odwala amawona kuchepa kwa mapiritsi.
Ndiosavuta kutenga, kulawa mwabwinobwino, osayambitsa kunyansidwa ndi gag Reflex. Ndikofunikira kuyang'anira bwino mlingo, makamaka kwa ana ndi okalamba. Ngati mukuyiwala kumwa mapiritsi, kulumpha pang'ono m'magazi a shuga ndikotheka.
Chifukwa chake, ndibwino kuti musaphonye kumwa ndi kumwa mankhwalawo momveka bwino ndi cholinga chake. ”
Georgy, wazaka 53, wazamaphunziro a endocrinologist, Saratov: "Masiku ano mankhwalawa akutchuka. Piritsi ndiyosavuta kumwa. Amakhala ochepa, otengeka msanga. Kulandila sikudalira chakudya.
Izi ndi zabwino kwa odwala omwe alibe mwayi wodya pafupipafupi. Mapiritsi akhazikitsa shuga m'magazi. Zotsatira zoyipa sizimachitika.
Ndizosatheka kupeza ma analogi pazinthu zomwe zimagwira, chifukwa nthawi zina pamafunika kupereka mankhwala ena a hypoglycemic. "
Kodi ochiritsa matenda ashuga ndi ati?
Olga, wazaka 43, ku Moscow: “Matenda a shuga adapezeka kalekale. Anathandizidwa ndi insulin. Koma panali zovuta zina pafupipafupi ndi kupezeka kwa mankhwalawo kuchipatala, ndipo m'mafakitala sizitha kupezeka nthawi zonse.
Dokotala adalangiza mapiritsi omwe angagwiritsidwe ntchito m'malo mwa chithandizo chamankhwala. Ndidayesa kugwiritsa ntchito Subetta. Kunena kuti ndakhuta sikungonena chilichonse. Mphamvu ya mankhwalawa ndiyabwino.
Zinthu zikuyenda bwino.
Tsopano simukuyenera kuyimirira pamzere wa mankhwala, mutha kungomwa mapiritsi katatu patsiku ndikumva bwino. Sindinamve zowawa zilizonse. Kuphatikiza apo, mapiritsi amasungunuka bwino, samakhala ndi kukoma kosasangalatsa komanso fungo. Ndizotsika mtengo, mutha kugula chithandizo chotere. ”
Vladislav, wazaka 57, Rostov-on-Don: “Sindikanathandizidwa ndi Subetta. Choyamba, chifukwa cha zovuta kukumbukira, nthawi zambiri ndimayiwala kumwa mapiritsi. Chifukwa cha izi, ndidamva bwino.
Dokotalayo anachenjeza kuti ndibwino kuphatikiza mankhwalawa ndi mankhwala ena othandizira matenda a shuga. Pakapita kanthawi, zotupa zenizeni zidatulukira pakhungu. Matenda ambiri amakhala akuipiraipira.
Matenda a Dyspeptic adawonekera.
Chilichonse chapita pambuyo pothana ndi mankhwalawo ndi chinanso. Adotolo adandifotokozera momwe thupi langa limachitikira chifukwa chakuti mankhwalawa amayamba kupezeka pakapangidwe kamankhwala. Mankhwalawa sanayenere. "
Chenjezo liyenera kumwedwa.
Anna, wazaka 22, ku St. Petersburg: “Ndakhala ndikudwala matenda a shuga kuyambira ndili mwana.Chifukwa chake, muubwana, chifukwa cha kusintha kwa mahomoni, adayamba kuchuluka msanga. Madokotala adapereka mankhwala osiyanasiyana kuti achepetse thupi, koma palibe chomwe chinathandiza.
Kenako pulofesa wina analimbikitsa mapiritsi a Subetta. Anatinso kuti mankhwalawa amapangidwira kuti azikhala ndi shuga wambiri, komanso kulemera.
Poyamba, sindinamve chilichonse, kupatula kungochotsa insulin. Koma kwenikweni patatha milungu iwiri, kulemera kunayamba kuchepa. Dokotalayo anakhazikitsa zakudya zapadera komanso zolimbitsa thupi pang'ono.
Tsopano ndimatsatira malangizo onse, ndili ndi thanzi labwino. ”
Pharmacokinetics
Ma pharmacokinetics a mankhwalawa sangaphunziridwe kwathunthu, chifukwa Mlingo wocheperako wa antibodies umakhala wovuta kupeza mu zinthu zachilengedwe, zimakhala ndi ziwalo zina. Chifukwa chake, palibe deta yeniyeni yokhudza metabolism ya mankhwalawa.
Ndani anapatsidwa
Amalandira mankhwala odwala matenda a shuga, omwe amatsutsana ndi insulin. Amagwiritsidwa ntchito ngati gawo la zovuta mankhwala.
Contraindication
Palibe zotsutsana mwamphamvu za kumwa mapiritsiwo. Kuletsa kotheratu ndi kokha kusalolera kwa ena pazinthu zina za mankhwalawo.
Ndi chisamaliro
Chenjezo liyenera kumwedwa mwa anthu okalamba ndi ana. Mwa ana, chitetezo chokwanira chimakhala chofooka, osapangidwa kwathunthu. Ma antibodies samapangidwa mwachangu, kotero, mankhwalawa amadzipatsa muyezo wochepetsetsa komanso kungokhala bwino munthawi ya chithandizo chachikulu.
Subetta imalembedwa kwa odwala omwe ali ndi matenda a shuga, momwe insulin imatchulidwira.
Okalamba ali ndi chiopsezo chachikulu cha mtima ndi mtima. Ngati zizindikiro zonse zaumoyo zikusintha, mankhwalawo amachotsedwa.
Chenjezo liyeneranso kuchitidwa pamaso pa mbiri ya matenda a impso ndi chiwindi. Pankhaniyi, muyenera kusintha mlingo wotsatira kuchuluka kwa thanzi la munthu.
Momwe mungatengere Subetta
Mapiritsiwo adapangira kuti pakhale pakamwa. Ayenera kusungidwa pakamwa mpaka mphindi yakutha kwathunthu. Osameza athunthu. Sizoletsedwa kumwa mapiritsi panthawi ya chakudya.
Ndi matenda ashuga
Mlingo wa mankhwalawa zimatengera kuuma kwa matenda, ndipo mwa ana, kulemera kwa thupi kumathandizidwanso. Ngati palibe zotsutsana ndi zoyipa, tikulimbikitsidwa kuti mutenge piritsi limodzi katatu pa tsiku. Chiwerengero cha mapiritsi patsiku chimadalira kuchuluka kwa chiphuphu chaz shuga ndipo chimakhazikitsidwa payekhapayekha kwa wodwala aliyense.
Zotsatira zoyipa Subetta
Mankhwalawa amaloledwa ndi magulu onse a odwala. Koma nthawi zina, zimachitika izi:
- mavuto a dyspeptic
- Hypersensitivity pazigawo,
- matupi awo sagwirizana ndi mawonekedwe a khungu totupa ndi kuyabwa.
Zotsatira zonse zoyipa zizipita pazokha mankhwala atatha. Izi ngati sizichitika, ndibwino kufunsa katswiri.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa samakhudza dongosolo lamkati lamanjenje. Chifukwa chake, kuthamanga kwa zochitika zama psychomotor ndi ndende sizisokoneza. Sizoletsedwa kuyendetsa magalimoto modziimira pawokha komanso makina olemera.
Malangizo apadera
Mwa kuperewera kwa impso ndi kwa kwa chiwindi, mulingo woyenera uyenera kuonedwa. Mikhalidwe ikasintha, kusintha kwa muyezo wofunikira kungafunike.
Kupatsa ana ntchito
Sikulimbikitsidwa kusankha ana osakwana zaka zitatu. Izi ndichifukwa satha kupukutira piritsi lokha ndipo akhoza kumeza lonse. Pambuyo pazaka zitatu, kumwa mankhwalawa amasankhidwa malinga ndi kulemera kwa mwana komanso kuchuluka kwa chindapusa cha matenda ashuga.
Gwiritsani ntchito pa nthawi yoyembekezera
Palibe njira yodalirika kuti mankhwalawa adutsa chotchinga ndi kulowa mkaka wa m'mawere.Chifukwa chake, mapiritsi amayikidwa pokhapokha ngati phindu kwa mayi lidzapambana zomwe zingavulaze mwana wosabadwayo.
Subetta simalimbikitsidwa kwa ana ochepera zaka zitatu.
Kuwoneka kwa zizindikiro za bongo kumatheka pokhapokha ngati wodwala mwangozi amatenga mapiritsi angapo nthawi.
Panthawi imeneyi, maonekedwe a mseru komanso kusanza, kutsegula m'mimba, komanso zovuta zina zam'mimba.
Chifukwa cha kutchulidwa kwakukulu, kutenga mapiritsi angapo a Subetta nthawi imodzi kumatha kupangitsa kuti magazi achepe kwambiri, omwe ndi owopsa kwa okalamba.
Kuchita ndi mankhwala ena
Palibe deta yodalirika ya momwe mankhwalawa amaphatikizidwira ndi mankhwala ena. Koma sikulimbikitsidwa kumwa mapiritsi ndi mankhwala ena kuti muchepetse matenda a shuga. Kuphatikiza apo, ndikosafunikanso kuphatikiza ndi mankhwala opangira zochizira kunenepa, mwachitsanzo ndi Dietress.
Kuyenderana ndi mowa
Simungathe kuphatikiza zakumwa zoledzeretsa ndi zakumwa zoledzeretsa. Ndi kuphatikiza uku, zizindikiro za kuledzera zimatha, ndipo mphamvu yogwiritsa ntchito mankhwalawa imachepa.
Subetta ilibe fanizo pazomwe zimagwira. Pali malo okhawo omwe amathandizira mankhwalawa omwe ali ndi vuto lofanana la hypoglycemic.
Sikulimbikitsidwa kumwa mapiritsi ndi mankhwala ena kuti muchepetse matenda a shuga.
Migwirizano ya Holiday ya Mankhwala
Mapiritsi amatha kugulidwa ku pharmacy iliyonse.
Kodi ndingagule popanda kulandira mankhwala?
Mankhwalawa ali pagulu la anthu. Mutha kugula popanda kupereka mankhwala kuchokera kwa dokotala.
Mtengo wa Subetta
Mtengo wa mankhwala umayamba kuchokera ku ma ruble 240. Koma mtengo wotsiriza umatengera malire azamankhwala ndi kuchuluka kwa mapiritsi omwe ali phukusi.
Zosungidwa zamankhwala
Sungani mapiritsi m'manyumba awo oyambira kutentha kwa chipinda. Pewani ana aang'ono mankhwala.
Tsiku lotha ntchito
Ndi zaka 3 kuyambira tsiku lopangira, zomwe zikuyenera kuwonetsedwa pazomwe zimapangidwira koyambirira.
Kuwoneka kwa zizindikiro za bongo kumatheka pokhapokha ngati wodwala mwangozi amatenga mapiritsi angapo nthawi.
Kampani yopanga: LLC NPF Materia Medica Holding.
Ndemanga za Subetta
Popeza mankhwalawa amagwiritsidwa ntchito kwambiri ndi magulu osiyanasiyana a odwala, mutha kupeza ndemanga zambiri za izi, osasiyidwa ndi akatswiri okha, komanso ndi odwala. Kuphatikiza apo, mankhwalawa amathandizira kuchepetsa thupi ndikuwonetsetsa kuti ali pamlingo woyenera mwa kuchepetsa shuga.
Roman, wazaka 47, wazachipatala, ku St. Petersburg: “Nthawi zambiri ndimapereka mankhwala kwa odwala anga. Kusakhutira ndi zomwe anachita machitidwe anga sizinali. Odwala amawona kuchepa kwa mapiritsi.
Ndiosavuta kutenga, kulawa mwabwinobwino, osayambitsa kunyansidwa ndi gag Reflex. Ndikofunikira kuyang'anira bwino mlingo, makamaka kwa ana ndi okalamba. Ngati mukuyiwala kumwa mapiritsi, kulumpha pang'ono m'magazi a shuga ndikotheka.
Chifukwa chake, ndibwino kuti musaphonye kumwa ndi kumwa mankhwalawo momveka bwino ndi cholinga chake. ”
Georgy, wazaka 53, wazamaphunziro a endocrinologist, Saratov: "Masiku ano mankhwalawa akutchuka. Piritsi ndiyosavuta kumwa. Amakhala ochepa, otengeka msanga. Kulandila sikudalira chakudya.
Izi ndi zabwino kwa odwala omwe alibe mwayi wodya pafupipafupi. Mapiritsi akhazikitsa shuga m'magazi. Zotsatira zoyipa sizimachitika.
Ndizosatheka kupeza ma analogi pazinthu zomwe zimagwira, chifukwa nthawi zina pamafunika kupereka mankhwala ena a hypoglycemic. "
Kodi ochiritsa matenda ashuga ndi ati?
Olga, wazaka 43, ku Moscow: “Matenda a shuga adapezeka kalekale. Anathandizidwa ndi insulin. Koma panali zovuta zina pafupipafupi ndi kupezeka kwa mankhwalawo kuchipatala, ndipo m'mafakitala sizitha kupezeka nthawi zonse.
Dokotala adalangiza mapiritsi omwe angagwiritsidwe ntchito m'malo mwa chithandizo chamankhwala. Ndidayesa kugwiritsa ntchito Subetta. Kunena kuti ndakhuta sikungonena chilichonse. Mphamvu ya mankhwalawa ndiyabwino.
Zinthu zikuyenda bwino.
Tsopano simukuyenera kuyimirira pamzere wa mankhwala, mutha kungomwa mapiritsi katatu patsiku ndikumva bwino. Sindinamve zowawa zilizonse. Kuphatikiza apo, mapiritsi amasungunuka bwino, samakhala ndi kukoma kosasangalatsa komanso fungo. Ndizotsika mtengo, mutha kugula chithandizo chotere. ”
Vladislav, wazaka 57, Rostov-on-Don: “Sindikanathandizidwa ndi Subetta. Choyamba, chifukwa cha zovuta kukumbukira, nthawi zambiri ndimayiwala kumwa mapiritsi. Chifukwa cha izi, ndidamva bwino.
Dokotalayo anachenjeza kuti ndibwino kuphatikiza mankhwalawa ndi mankhwala ena othandizira matenda a shuga. Pakapita kanthawi, zotupa zenizeni zidatulukira pakhungu. Matenda ambiri amakhala akuipiraipira.
Matenda a Dyspeptic adawonekera.
Chilichonse chapita pambuyo pothana ndi mankhwalawo ndi chinanso. Adotolo adandifotokozera momwe thupi langa limachitikira chifukwa chakuti mankhwalawa amayamba kupezeka pakapangidwe kamankhwala. Mankhwalawa sanayenere. "
Chenjezo liyenera kumwedwa.
Anna, wazaka 22, ku St. Petersburg: “Ndakhala ndikudwala matenda a shuga kuyambira ndili mwana. Chifukwa chake, muubwana, chifukwa cha kusintha kwa mahomoni, adayamba kuchuluka msanga. Madokotala adapereka mankhwala osiyanasiyana kuti achepetse thupi, koma palibe chomwe chinathandiza.
Kenako pulofesa wina analimbikitsa mapiritsi a Subetta. Anatinso kuti mankhwalawa amapangidwira kuti azikhala ndi shuga wambiri, komanso kulemera.
Poyamba, sindinamve chilichonse, kupatula kungochotsa insulin. Koma kwenikweni patatha milungu iwiri, kulemera kunayamba kuchepa. Dokotalayo anakhazikitsa zakudya zapadera komanso zolimbitsa thupi pang'ono.
Tsopano ndimatsatira malangizo onse, ndili ndi thanzi labwino. ”
Zachipatala ndi gulu la mankhwala
Oral hypoglycemic mankhwala
Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD
Mapiritsi okhala ndi mafilimu chikasu, mozungulira, biconvex, wolemba "5" mbali imodzi ndi "1427" mbali inayo.
| 1 tabu | |
| dapagliflozin propanediol monohydrate | 6.15 mg |
| zomwe zimagwirizana ndi zomwe zili dapagliflozin | 5 mg |
Omwe amathandizira: cellcrystalline cellulose - 85.725 mg, anactrous lactose - 25 mg, crospovidone - 5 mg, silicon dioxide - 1.875 mg, magnesium stearate - 1.25 mg.
Ma Shell: Opadry II chikasu - 5 mg (polyvinyl mowa pang'ono hydrolyzed - 2 mg, titanium dioxide - 1.177 mg, macrogol 3350 - 1.01 mg, talc - 0,74 mg, iron utoto wachikuda oxide - 0,073 mg).
Ma PC 10 - mabulosi a aluminiyamu zojambulazo (3) - mapaketi okhala ndi makatoni okhala ndi njira yoyamba yotsegulira.
Mapiritsi okhala ndi mafilimu wachikasu, mawonekedwe a diamondi, biconvex, wolemba "10" mbali imodzi ndi "1428" mbali inayo.
| 1 tabu | |
| dapagliflozin propanediol monohydrate | 12,3 mg |
| zomwe zimagwirizana ndi zomwe zili dapagliflozin | 10 mg |
Omwe amathandizira: cellcrystalline cellulose - 171.45 mg, anactrous lactose - 50 mg, crospovidone - 10 mg, silicon dioxide - 3,75 mg, magnesium stearate - 2.5 mg.
Ma Shell: Opadry II wachikasu - 10 mg (pang'ono hydrolyzed polyvinyl mowa - 4 mg, titanium dioxide - 2.35 mg, macrogol 3350 - 2.02 mg, talc - 1.48 mg, utoto wachikasu wachitsulo - 0,15 mg).
Ma PC 10 - mabulosi a aluminiyamu zojambulazo (3) - mapaketi okhala ndi makatoni okhala ndi njira yoyamba yotsegulira.
Zotsatira za pharmacological
Dapagliflozin ndi potent (Kihibitilamu wosasinthika (Ki) wa 0,55 nM), chosankha chosinthira chosankha cha mtundu wa 2 sodium glucose cotransporter (SGLT2). SGLT2 imafotokozedwa mosamala mu impso ndipo sapezeka m'matumbo ena opitilira 70 (kuphatikiza
mu chiwindi, minofu yam'magazi, minofu ya adipose, gland ya mammary, chikhodzodzo ndi ubongo).SGLT2 ndiye chonyamula chachikulu cha glucose reabsorption mu aimpso tubules.
Glucose reabsorption mu aimpso tubules kwa odwala omwe ali ndi matenda a shuga 2 mellitus (T2DM) akupitiliza ngakhale hyperglycemia. Mwa kuletsa kusinthika kwa impso m'magazi, dapagliflozin imachepetsa kugundika kwa impso tubules, zomwe zimapangitsa kuti shuga akhale impso.
Zotsatira za dapagliflozin ndikuchepa kwa glucose othamanga ndipo mutatha kudya, komanso kuchepa kwa kuchuluka kwa hemoglobin ya glycosylated kwa odwala omwe ali ndi matenda a shuga a 2.
Kuchotsa glucose (glucosuric athari) kumachitika mutamwa mankhwala oyamba, umapitirira kwa maola 24 otsatira ndikupitilira chithandizo chonse.
Kuchuluka kwa shuga komwe impso zimapangidwa chifukwa cha njirayi kumadalira kuchuluka kwa shuga m'magazi komanso kuchuluka kwa kusefedwa kwa glomerular (GFR). Dapagliflozin sichimasokoneza kupanga kwachilendo kwa glucose amkati poyankha hypoglycemia.
Zotsatira za dapagliflozin ndizodziyimira payekha paz insulin komanso insulin sensitivity. M'maphunziro azachipatala a mankhwalawa, Forsig adawonetsa kusintha kwa β-cell function (mayeso a HOMA, kuwunika kwa homeostasis).
Kuwonongeka kwa shuga ndi impso zomwe zimayambitsidwa ndi dapagliflozin limodzi ndi kuchepa kwa zopatsa mphamvu komanso kuchepa kwa thupi. Dapagliflozin zoletsa wa sodium glucose cotransport limodzi ndi ofooka okodzetsa ndi osakhalitsa natriuretic zotsatira.
Dapagliflozin ilibe gawo lililonse kwa anthu ena omwe amayendetsa glucose omwe amatengera glucose kuzinthu zotumphukira ndikuwonetsa kupitirira 1,400 nthawi yayikulu pakusankha kwa SGLT2 kuposa SGLT1, transporter yayikulu yamatumbo yomwe imayendetsa mayamwidwe a glucose.
Atamwa dapagliflozin ndi odzipereka athanzi komanso odwala matenda amtundu wa 2, kuwonjezeka kwa glucose komwe anapatsidwa ndi impso kunawonedwa.
Pamene dapagliflozin adamwa mlingo wa 10 mg / tsiku kwa masabata 12, mwa odwala T2DM, pafupifupi 70 g ya glucose adamuchotsa impso patsiku (zomwe zimafanana ndi 280 kcal / tsiku).
Odwala omwe ali ndi matenda a shuga a mtundu wa 2 omwe adatenga dapagliflozin pa 10 mg / tsiku kwa nthawi yayitali (mpaka zaka ziwiri), shuga wa mayamwidwe adasungidwa panthawi yonse ya mankhwala.
Kuchulukanso kwa shuga kwa impso ndi dapagliflozin kumathandizanso kuti osmotic diuresis ndi kuchuluka kwa mkodzo kuchuluka.
Kuwonjezeka kwa kuchuluka kwa mkodzo kwa odwala omwe ali ndi matenda amtundu wa 2 akumamwa dapagliflozin pa 10 mg / tsiku lokhalokha kwa masabata 12 ndipo limafikira pafupifupi 375 ml / tsiku.
Kuchuluka kwa kuchuluka kwa mkodzo kumayendera limodzi ndi kuchepa kwa pang'onopang'ono kwa impso, komwe sikunapangitse kusintha kwa kuchuluka kwa sodium mu seramu yamagazi.
Kuwunikira komwe kumakonzedwa pazotsatira za maphunziro 13 olamulidwa ndi placebo akuwonetsa kuchepa kwa systolic magazi (SBP) ya 3.7 mm Hg. ndi diastolic magazi (DBP) pa 1.8 mm Hg pa sabata la 24 la dapagliflozin Therapy pa 10 mg / tsiku poyerekeza ndi kuchepa kwa SBP ndi DBP ndi 0,5 mm Hg. pagulu la placebo. Kutsika kofananako kwa kuthamanga kwa magazi kunawonedwa m'milungu ya 104 ya chithandizo.
Mukamagwiritsa ntchito dapagliflozin pa 10 mg / tsiku kwa odwala omwe ali ndi matenda a shuga 2 omwe ali ndi vuto losakwanira glycemic komanso matenda oopsa, kulandira angiotensin II receptor blockers, ACE inhibitors
kuphatikiza ndi mankhwala ena a antihypertensive, kuchepa kwa hemoglobin ya glycosylated ndi 3.1% ndi kuchepa kwa SBP ndi 4.3 mm Hg. Pambuyo pa milungu 12 ya mankhwala poyerekeza ndi placebo.
Pharmacokinetics
Pambuyo pakukonzekera kwa pakamwa, dapagliflozin imatengedwa mwachangu komanso kuchokera m'matumbo ndipo imatha kutengedwa nthawi yonse ya chakudya komanso kunja kwake. Cmax ya dapagliflozin m'madzi am'magazi nthawi zambiri imatheka mkati mwa maola 2 mutatha kudya. Makhalidwe a Cmax ndi AUC amawonjezeka molingana ndi mlingo wa dapagliflosin.
Mtheradi bioavailability wa dapagliflozin pamene kumwa pakamwa 10 mg ndi 78%.Kudya kunali ndi zolimbitsa pa pharmacokinetics ya dapagliflozin mwa odzipereka athanzi. Chakudya chamafuta kwambiri chidachepetsa Cmax ya dapagliflozin ndi 50%, kukulitsa Tmax mu plasma pafupifupi ola limodzi, koma sizinakhudze AUC poyerekeza ndi kusala kudya.
Kusintha kumeneku sikofunikira mwakuthupi.
Kumangidwa kwa dapagliflozin kupita ku mapuloteni a plasma kuli pafupifupi 91%. Odwala omwe ali ndi matenda osiyanasiyana, mwachitsanzo, omwe ali ndi vuto laimpso kapena kwa chiwindi, chizindikiro ichi sichinasinthe.
Dapagliflozin ndi glucoside yolumikizidwa ndi C yomwe aglycon yake imalumikizidwa ndi glucose ndi mgwirizano wa kaboni-kaboni, womwe umatsimikizira kukhazikika kwake pakulimbana ndi glucosidases. Dapagliflozin imapangidwa kuti ipange metabolite yovuta kwambiri ya dapagliflozin-3-O-glucuronide.
Pambuyo pakamwa 50 mg ya 14C-dapagliflozin, 61% ya mlingo womwe unatengedwa umapangidwira dapagliflozin-3-O-glucuronide, womwe umakhala wa 42% ya kuchuluka kwa plasma radioacaction (maola AUC0-12). Mankhwala osasinthika amakhala ndi 39% ya kuchuluka kwa plasma radioactivity.
Zigawo za metabolites zomwe zatsala payekhapayekha sizidutsa 5% ya kuchuluka kwa madzi am'magazi. Dapagliflozin-3-O-glucuronide ndi ma metabolites ena alibe mankhwala.
Dapagliflozin-3-O-glucuronide imapangidwa ndi enzyme uridine diphosphate glucuronosylasease 1A9 (UGT1A9), yomwe imapezeka m'chiwindi ndi impso, ndipo CYP cytochrome isoenzymes sakukhudzidwa ndi metabolism.
Wapakati plasma T1 / 2 mwa odzipereka athanzi anali 12,9 maola pambuyo pakamwa limodzi dapagliflozin pa 10 mg.
Dapagliflozin ndi ma metabolites ake amachotsedwa makamaka ndi impso, ndipo ndi ochepera 2% omwe amachotsedwa osasinthika. Mutatenga 50 mg ya 14C-dapagliflozin, 96% ya radioacaction idapezeka - 75% mkodzo ndi 21% mu ndowe.
Pafupifupi 15% ya ma radioacuction omwe amapezeka mu ndowe amachokera ku dapagliflozin yosasinthika.
Pharmacokinetics mu milandu yapadera yamankhwala
Odwala ndi mkhutu aimpso ntchito.
Pa equilibrium (ndikutanthauza AUC), kuwonekera kwa makonzedwe a dapagliflozin mwa odwala omwe ali ndi matenda a shuga a 2 komanso ofatsa, ochepa kapena ochepa aimpso (monga momwe iohexol chilolezo) anali 32%, 60%, ndi 87% kuposa omwe amapezeka ndi odwala matenda a shuga 2 impso, motero. Kuchuluka kwa shuga komwe impso zimatenga masana mutatenga dapagliflozin mu ofanana kumadalira boma la impso. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri ndi aimpso kugwira ntchito, komanso mofatsa, pang'ono kapena pang'ono, aimpso, 85, 52, 18, ndi 11 g shuga amatsitsidwa tsiku lililonse. Panalibe kusiyana pakumanga kwa dapagliflozin kupangira mapuloteni mu odzipereka athanzi komanso odwala omwe amalephera kupweteka aimpso. Sizikudziwika ngati hemodialysis imakhudzana ndi mawonekedwe a dapagliflozin.
Odwala omwe ali ndi vuto la chiwindi. Odwala omwe ali ndi kuchepa pang'ono kapena kosakwanira kwa hepatic, osachepera Cmax ndi AUC ya dapagliflozin anali 12% ndi 36% apamwamba, motero, poyerekeza ndi odzipereka athanzi.
Kusiyana kumeneku sikofunikira kuchipatala, motero, kusintha kwa dapagliflozin kwa chiwindi chochepa komanso chochepa sikufunika.
Odwala omwe ali ndi vuto lolemera la hepatic (Mwana-Pugh kalasi C), Cmax wamba ndi AUC ya dapagliflozin anali 40% ndi 67% apamwamba, motero, poyerekeza ndi odzipereka athanzi.
Odwala okalamba (zaka ≥65). Panalibe kuwonjezeka kwakadwala kovuta kwambiri kwa odwala omwe ali ndi zaka zosakwana 70 (pokhapokha ngati zifukwa zina sizakukhudzidwa). Komabe, kuwonjezeka kwawonetsero kungayembekezeredwe chifukwa kuchepa kwa ntchito yaimpso yolumikizidwa ndi zaka. Zambiri zowonekera kwa odwala azaka zopitilira 70 ndizosakwanira.
Paulo Mwa akazi, AUC wamba pamlingo wofanana ndi 22% kuposa kuposa amuna.
Kuyanjana ndi mitundu. Palibe kusiyana kwakukulu pakumwonekera kwatsatanetsatane komwe kunapezeka pakati pa oimira amipikisano ya Caucasian, Negroid ndi Mongoloid.
Kulemera kwa thupi. Makhalidwe otsika kwambiri ndi kulemera kwamphamvu kwa thupi adadziwika. Chifukwa chake, mwa odwala omwe ali ndi thupi lozama, kuwonekera pang'ono kungadziwike, ndipo mwa odwala omwe ali ndi thupi lochulukirapo - kuchepa kwa chiwonetsero cha dapagliflozin. Komabe, kusiyana kumeneku sikofunikira mwamaganizidwe.
Type 2 shuga mellitus kuwonjezera pa zakudya ndi masewera olimbitsa thupi kuti muthe kuyendetsa bwino glycemic control:
- zowonjezera ku mankhwala a Metformin, sulfonylurea zotumphukira (kuphatikizapo kuphatikiza ndi metformin), thiazolidinediones, dipeptidyl peptidase 4 (DPP-4) zoletsa (kuphatikiza ndi metformin), kukonzekera insulini (kuphatikiza insulin kuphatikiza mankhwala amodzi kapena awiri a hypoglycemic operekera pakamwa) pakakhala kuti palibe chithandizo chokwanira cha glycemic mu mankhwalawa.
- Kuyambitsa kuphatikiza mankhwala ndi metformin, ngati mankhwalawa alangizidwa.
Contraindication
- lembani matenda ashuga 1
- Kulephera kuwononga kwakanthawi komanso koopsa (GFR)
Forsiga - chida chatsopano chothandizira matenda a shuga
Posachedwa, gulu latsopano la othandizira a hypoglycemic omwe ali ndi vuto lina losiyana siyana apezeka kwa odwala matenda ashuga ku Russia.
Mankhwala oyamba a Forsig a matenda a shuga a 2 adalembedwa m'dziko lathu, zidachitika mchaka cha 2014.
Zotsatira za kafukufuku wa mankhwalawa ndizosangalatsa, kugwiritsa ntchito kwake kumatha kuchepetsa kwambiri mankhwalawa omwe amamwa, ndipo nthawi zina amatha kupatula jakisoni wa insulin pazovuta za matendawa.
Ndemanga za endocrinologists ndi odwala ndizosakanikirana. Wina amasangalala ndi mwayi watsopano, ena amakonda kudikira mpaka zotsatira za kumwa mankhwalawo kwa nthawi yayitali kuti zidziwike.
Kodi mankhwala a Forsig amagwira ntchito bwanji
Zotsatira za mankhwala a Forsig zimatengera luso la impso kuti lisonkhanitse shuga m'magazi ndikuchotsa mkodzo. Mwazi m'thupi lathu umadetsedwa nthawi zonse ndi zinthu zopangidwa ndi metabolism komanso poizoni.
Udindo wa impso ndikuwunika zinthu izi ndikuzichotsa. Chifukwa cha izi, magazi amadutsa mu mawonekedwe a impso kangapo patsiku. Pachigawo choyamba, zigawo zama protein zokha za magazi sizidutsa mu fayilo, madzi ena onse amalowa glomeruli.
Izi ndiye zotchedwa kuti mkodzo woyamba, makumi a malita amapangidwa masana.
Kuti mukhale wachiwiri ndikulowa chikhodzodzo, madzi osefedwa amayenera kuzikirapo. Izi zimatheka mu gawo lachiwiri, pamene zinthu zonse zofunikira - sodium, potaziyamu, ndi zinthu zamagazi - zimatengedwanso m'magazi mu mawonekedwe osungunuka.
Thupi limaganiziranso kuti shuga ndiyofunika, chifukwa ndi omwe amapatsa mphamvu minofu ndi ubongo. Mapuloteni apadera a SGLT2 amabweza magazi. Amapanga mtundu wamtunda mu thumba la nephron, lomwe shuga limadutsa m'magazi.
Mwa munthu wathanzi, glucose imabweranso kwathunthu, mwa wodwala yemwe ali ndi matenda a shuga, amalowa mkodzo pang'ono pomwe mulingo wake umaposa gawo la impso la 9-10 mmol / L.
Zomwe zimagwira ntchito ya Forsigi ndi dapagliflozin, ndizoletsa zama protein a SGLT2. Izi zikutanthauza kuti amatha kupondaponda ntchito yawo. Kuyamwa kwa glucose kuchokera mkodzo woyamba kumachepa, amayamba kuwonjezeredwa ndi impso mokulira.
Zotsatira zake, kuchuluka kwa magazi kumatsitsa glucose, mdani wamkulu wamitsempha yamagazi ndi chifukwa chachikulu cha zovuta zonse za shuga.
Mbali yodziwika bwino ya dapagliflozin ndiyosavuta kusankha, ilibe gawo lililonse pama glucose omwe amayendetsa minofu ndipo samasokoneza mayamwidwe ake.
Pa mulingo woyenera wa mankhwalawa, pafupifupi 80 g ya shuga imatulutsidwa mkodzo patsiku, mopitilira kuchuluka kwa insulini yopangidwa ndi kapamba, kapena kupeza jakisoni. Zisakhudze kuchuluka kwa Forsigi ndi kukhalapo kwa insulin. Komanso, kuchepa kwa shuga m'magazi kumathandizira kudutsa kwa shuga otsala kudzera mu cell.
Momwe milandu amaikidwira
Forsyga sangathe kuchotsa shuga onse owonjezera ndi mafuta osamwa osagwirizana ndi chakudya. Monga othandizira ena a hypoglycemic, kudya ndi kuchita zolimbitsa thupi pakugwiritsa ntchito ndizofunikira. Nthawi zina, monotherapy ndi mankhwalawa ndizotheka, koma nthawi zambiri endocrinologists amalembera Forsig limodzi ndi Metformin.
Kukhazikitsidwa kwa mankhwala mu milandu yotsatirawa ndikulimbikitsa:
- kuwongolera kuchepa kwa odwala omwe ali ndi matenda a shuga a 2,
- Ngati njira yowonjezerapo ngati mukudwala kwambiri,
- kukonza zolakwika zazakudya nthawi zonse,
- pamaso pa matenda omwe amalepheretsa zolimbitsa thupi.
Pochiza matenda a shuga 1, mankhwalawa saloledwa, popeza kuchuluka kwa glucose omwe amagwiritsidwa ntchito ndi chithandizo chake ndikosiyanasiyana ndipo kumatengera zinthu zambiri. Ndikosatheka kuwerengera moyenera kuchuluka kwa insulini mumkhalidwe wotere, womwe umadzaza ndi hypo- ndi hyperglycemia.
Ngakhale adachita bwino kwambiri komanso kuwunika kwabwino, a Forsiga sanalandire zofalitsa zambiri. Pali zifukwa zingapo izi:
- mtengo wake wokwera
- nthawi yokwanira yophunzira,
- zimangokhudza chizindikiro cha matenda ashuga osakhudza zomwe zimayambitsa,
- zovuta za mankhwala.
Malangizo ogwiritsira ntchito mankhwalawa
Forsig amapezeka mu mawonekedwe a mapiritsi a 5 ndi 10 mg. Analimbikitsa tsiku lililonse mankhwala popanda contraindication nthawi zonse - 10 mg. Mlingo wa metformin amasankhidwa payekha. Matenda a shuga akapezeka, Forsig nthawi zambiri amapatsidwa 10 mg ndi 500 mg ya metformin, pambuyo pake mlingo wa chomaliza umasinthidwa malinga ndi zomwe zikuwonetsa mu mita.
Zochita za piritsi zimatha maola 24, motero mankhwalawa amatengedwa 1 nthawi patsiku. Kuzindikira kwathunthu kwa Forsigi sikudalira kuti mankhwalawo adamwa pamimba yopanda kanthu kapena ndi chakudya. Chachikulu ndikumwa kumwa ndi madzi okwanira ndikuonetsetsa kuti pakhale Mlingo wofanana.
Mankhwalawa amakhudza kuchuluka kwa mkodzo tsiku lililonse, kuti muchepetse 80 g shuga, pafupifupi 375 ml ya madzi amathandizanso. Uwu ndi pafupifupi ulendo wina wowonjezera kuchimbudzi tsiku lililonse. Madzi otaika amayenera kulowedwa m'malo kuti athetse kusowa kwamadzi. Chifukwa chothetsa gawo lina la glucose mukamamwa mankhwalawo, zopatsa mphamvu zonse za kalori zimatsika ndi zopatsa mphamvu 300 patsiku.
>> Diabeteson MV - momwe angatengere ndi chifukwa chake akatswiri amasankha.
Kodi zingathandize kuti muchepetse kunenepa
Pakufotokozeratu mankhwalawo, wopanga Forsigi amadziwitsa za kuchepa kwa thupi komwe kumawonedwa pakumwa. Izi zimadziwika makamaka kwa odwala matenda a shuga ochita kunenepa kwambiri.
Dapagliflozin amagwira ntchito monga okodzetsa pang'ono, amachepetsa kuchuluka kwa madzi mthupi. Ndilemera kwambiri komanso kupezeka kwa edema, awa ndi madzi osachepera 3-5 kg sabata yoyamba.
Zotsatira zofananazo zitha kuchitika mwa kusinthira ku zakudya zopanda mchere ndikuchepetsa kwambiri kuchuluka kwa chakudya - thupi limayamba kuchotsa chinyezi chosafunikira.
Chifukwa chachiwiri chakuchepetsa thupi ndi kuchepa kwama calories chifukwa kuchotsedwa kwa gawo la shuga. Ngati 80 g ya glucose imatulutsidwa mkodzo patsiku, izi zimataya kuchepa kwa zopatsa mphamvu 320.
Kuti muchepetse kilogalamu yakulemera chifukwa cha mafuta, muyenera kuchotsa ma calories a 7716, ndiye kuti, kutaya kilogalamu imodzi kumatenga masiku 24. Zikuwonekeratu kuti Forsig angachite pokhapokha ngati pali zakudya zopanda thanzi.
Kuti mukhale okhazikika, kuchepa thupi kuyenera kutsatira zakudya zomwe simukudwala ndipo musaiwale za maphunziro.
Anthu athanzi sayenera kugwiritsa ntchito Forsigu pakuchepetsa thupi. Mankhwalawa amagwira ntchito kwambiri ndi misempha yayikulu yamagazi.Kuyandikira kwambiri kwachilendo, kumachepetsa mphamvu ya mankhwalawo. Musaiwale za kupsinjika kwakukulu kwa impso ndi chidziwitso chosakwanira pakugwiritsa ntchito mankhwalawa.
Forsyga imangopezeka ndi mankhwala okha ndipo imangoperekedwa kwa odwala omwe ali ndi matenda a shuga a 2.
Ndemanga za Odwala
Amayi anga ali ndi matenda ashuga oopsa. Tsopano pa insulin, amayendera pafupipafupi wa ophthalmologist, wachita kale maopareshoni 2, masomphenya ake akugwa. Azakhali anga nawonso ali ndi matenda ashuga, koma zonse ndizosavuta. Nthawi zonse ndimkaopa kuti banja langa lingandipweteke, koma sindidaganiziratu.
Ndili ndi zaka 40 zokha, ana sanamalize sukulu. Ndinayamba kumva kuwawa, kufooka, chizungulire. Pambuyo pa mayeso oyamba, chifukwa chake chinapezeka - shuga 15.
The endocrinologist adandiuza Forsig ndi zakudya zokha, koma pokhapokha nditatsatira malamulowo ndikupita kumaphwando nthawi zonse. Mafuta a m'magazi anachepa bwino, mpaka pafupifupi 7 pazaka 10.
Tsopano miyezi isanu ndi umodzi yadutsa, sindinatumizidwe mankhwala ena, ndikumva bwino, ndataya 10 kg panthawiyi. Tsopano pang'onopang'ono: Ndikufuna kuti ndichepetse chithandizo ndikuwona ngati nditha kupitiliza shuga ndekha, pakudya kokha, koma adokotala samalola.
Ndimamwanso Forsigu. Kungoti sindinayende bwino. Mwezi woyamba - bakiteriya vaginitis, amamwa maantibayotiki. Pambuyo 2 milungu - thrush. Pambuyo pake, kumangokhala chete. Zotsatira zabwino - adachepetsa mlingo wa Siofor, chifukwa m'mawa udayamba kugwedezeka kuchokera shuga wochepa.
Ndi kuchepa thupi mpaka pano, ngakhale ndakhala ndikumwa Forsigu miyezi itatu. Zotsatira zoyipa sizikabweranso, ndikupitiliza kumwa, ngakhale mitengo yankhanza.Tigula agogo a Forsig. Adasunthira dzanja lake pachakudya chake cha shuga ndipo sasiya maswiti.
Amamva kuwawa, kupanikizika, kudumpha, madokotala amamuika pachiwopsezo cha matenda a mtima. Ndinkamwa mankhwala ambiri ndi mavitamini, ndipo shuga adangokula. Atayamba kudya kwa Forsigi, thanzi la agogo anga litatha pafupifupi milungu iwiri, kupanikizika kunasiya kuchoka pa 200. Shuga amachepa, koma akadali monga abwinobwino.
Tsopano tikufuna kumuyika pakudya - ndikunyengerera, ndikuwawopsa. Ngati izi sizingatheke, adotolo adawopseza kuti awusamutsa ku insulin.
Kodi fanizo ndi chiyani
Mankhwala a Forsig ndi mankhwala okhawo omwe amapezeka m'dziko lathu ndi dapagliflozin. Zofananira zonse za Forsigi choyambirira sizipangidwa. Monga cholowa mmalo, mutha kugwiritsa ntchito mankhwala aliwonse kuchokera mgulu la ma glyphosins, machitidwe omwe amatengera zoletsa za SGLT2. Mankhwala awiri otere adapereka kulembetsa ku Russia - Jardins ndi Invokana.
| Dzinalo | Zogwira ntchito | Wopanga | Mlingo | Mtengo (mwezi wololeza) |
| Forsyga | dapagliflozin | Makampani a Bristol Myers squibb, USAAstraZeneca UK Ltd, UK | 5 mg, 10 mg | 2560 rub. |
| Jardins | empagliflozin | Beringer Ingelheim International, Germany | 10 mg, 25 mg | 2850 rub. |
| Attokana | canagliflozin | Johnson & Johnson, USA | 100 mg, 300 mg | 2700 rub. |
Mitengo yoyenerera ya Forsigu
Mwezi umodzi wothira mankhwala Forsig udzagula pafupifupi ma ruble 5,000. Kunena zowona, sikotsika mtengo, makamaka mukamaganizira za omwe ali ndi mavitamini ofunikira, mavitamini, zotsekemera za glucometer, ndi zina zoyimira shuga. Posachedwa, zinthu sizisintha, popeza mankhwalawo ndi atsopano, ndipo wopanga amafunanso kubwezeretsanso ndalama zomwe zakhazikitsidwa pachitukuko ndi kafukufuku.
Kuchepetsa kwa mitengo kungayembekezeredwe pokhapokha kutulutsidwa kwa ma jenetiki - ndalama zomwe zimapangidwa ndi ena opanga. Otsutsana nawo otsika mtengo sawonekera pofika chaka cha 2023, chitetezo cha patent cha Forsigi chikadzatha, wopanga zinthu zoyambirira ataya ufulu wake wapadera.
Mankhwala a shuga
Mankhwala a shuga: 133 mankhwala, malangizo (mawonekedwe omasulidwa ndi Mlingo), infographics (Zizindikiro, zotsutsana, zotsatira zoyipa), ndemanga 165 za madokotala ndi odwala.
23 ndemanga | ||||
Mtengo kuchokera 46 mpaka 771 rubles. | ||||
Mtengo kuchokera ku ma 104 rubles mpaka 862. | ||||
Mtengo kuchokera ku 580 mpaka 1027 rubles. | ||||
Mtengo kuchokera 464 mpaka 1029 rubles. | ||||
Mtengo kuchokera 215 mpaka 787 rubles. | ||||
6 ndemanga | ||||
Mtengo kuchokera ku 160 mpaka 587 rubles. | ||||
Mtengo kuchokera pa ma ruble 545 mpaka 1575. | ||||
Mtengo kuchokera ku 938 mpaka 3594 rubles. | ||||
| Mtengo kuchokera pa 290 mpaka 733 rubles. | ||||
| Mtengo kuchokera pa ma ruble 51 mpaka 730. | ||||
Mtengo kuchokera ku 118 mpaka 4178 rubles. | ||||
| Mtengo kuchokera pa ma ruble 61 mpaka 605. | ||||
| Mtengo kuchokera 750 mpaka 2480 rubles. | ||||
| Mtengo kuchokera 1742 mpaka 2104 rubles. |
Mapiritsi a shuga - mndandanda wa mankhwala abwino kwambiri
Mapiritsi a shuga amasankhidwa kutengera mtundu wamatenda, omwe amagawidwa m'mitundu iwiri: wodalira insulin komanso osafuna kuyambitsa insulin. Musanayambe chithandizo, werengani kagawidwe ka mankhwala ochepetsa shuga, momwe amagwirira ntchito gulu lililonse komanso contraindication kuti agwiritse ntchito.
Kumwa mapiritsi ndi gawo limodzi la moyo wa anthu odwala matenda ashuga.
Gulu la mapiritsi a shuga
Mfundo za chithandizo cha matenda ashuga ndizosunga shuga pamlingo wa 4.0-5,5 mmol / L. Kuti muchite izi, kuwonjezera pa kutsatira zakudya zamafuta ochepa komanso kuchita masewera olimbitsa thupi pafupipafupi, ndikofunikira kumwa mankhwala oyenera.
Mankhwala ochizira matenda a shuga amagawika m'magulu akulu akulu.
Zothandiza kuchokera ku sulfonylureas
Mankhwalawa odwala matenda ashuga ali ndi vuto la hypoglycemic chifukwa cha beta - maselo omwe ali ndi vuto lopanga insulin mu kapamba. Njira za gululi zimachepetsa chiwopsezo cha impso ntchito ndi kukula kwa matenda amtima.
Maninil - mapiritsi otsika mtengo a odwala matenda ashuga
Mndandanda wazomwe zimachokera ku sulfonylurea:
| Mutu | Malamulo Ovomerezeka | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Diabetes | Kumayambiriro kwa chithandizo, imwani piritsi limodzi patsiku ndi chakudya. M'tsogolomu, mlingo umatha kuwonjezeredwa kukhala zidutswa 2-3 patsiku | Coma, pakati, impso ndi chiwindi kulephera | 30 | 294 |
| Ziphuphu | Mlingo woyambirira ndi mapiritsi 0,5 m'mawa nthawi ya chakudya cham'mawa. Popita nthawi, kuchuluka kumawonjezeka mpaka zidutswa 4 patsiku | Kubereka ndi kuyamwitsa, chikomokere ndi chikhalidwe cha makolo, odwala matenda ashuga | 60 | 412 |
| Maninil | Mlingo umachokera kwa mapiritsi 0,5 mpaka 3. | Ketoacidosis, hyperosmolar chikomokere, matumbo kutsekeka, aimpso ndi kwa chiwindi kulephera, pakati, leukopenia, matenda opatsirana | 120 | 143 |
| Amaril | Imwani 1-4 mg ya mankhwala patsiku, kumwa mapiritsi okhala ndi madzi ambiri | Kuwonongeka kwa chiwindi ndi impso, galactose tsankho, kuchepa kwa mkaka, pakati ndi mkaka wa m`mawere, | 30 | 314 |
| Glidiab | Tengani 1 ora limodzi musanadye m'mawa ndi madzulo | Mitsempha yotsekemera, leukopenia, matenda a impso ndi chiwindi choopsa, kutsutsana ndi gliclazide, kubereka ndi kudyetsa ana, matenda a chithokomiro, uchidakwa | 739 |
Meglitinides
Mankhwala a anthu odwala matenda ashuga a gululi ndi ofanana mu njira zochizira zotumphukira zotuluka za sulufayiti ndikuthandizira kupanga insulin. Kuchita kwawo kumatengera shuga.
Novonorm ndiyofunikira pakupanga insulin
Mndandanda wa meglitinides abwino:
| Dzinalo | Njira yolandirira | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Novonorm | Imwani 0,5 mg wa mankhwala mphindi 20 musanadye.Ngati ndi kotheka, mlingo ukuwonjezeka nthawi 1 pa sabata mpaka 4 mg | Matenda opatsirana, matenda ashuga komanso ketoacidosis, kubereka ndi kudyetsa, chiwindi ntchito | 30 | 162 |
| Starlix | Idyani theka la mphindi 30 chakudya chachikulu chisanachitike | Zaka mpaka zaka 18, kutenga pakati, kuyamwa, nateglinide tsankho, matenda a chiwindi | 84 | 2820 |
Pochiza matenda a shuga omwe amadalira insulin, meglitinides sagwiritsidwa ntchito.
Mankhwala a gululi amalepheretsa kuti shuga azituluka m'chiwindi komanso amathandizira kuti lizilowetsedwa mosavuta m'thupi lathu.
Mankhwala osokoneza bongo wabwino
Magulu amakulu othandiza kwambiri:
| Dzinalo | Njira yolandirira | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Metformin | Imwani chakudya 1 mukatha kudya. Mutha kuonjezera mlingo pambuyo masiku 10-15 a mankhwalawa 3 mapiritsi | Wotsika zaka 15 | 60 | 248 |
| Siofor | Tengani zidutswa 1-2 ndi madzi ambiri. Pazipita tsiku lililonse mapiritsi 6. Ntchito kuchepa kwa shuga | Type 1 shuga mellitus, aimpso, kupuma komanso chiwindi, lactic acidosis, zakudya zochepa zama calorie, uchidakwa, kubereka ana komanso kudyetsa, myocardial infaration, opaleshoni yaposachedwa | 314 | |
| Glucophage | Kumayambiriro kwa mankhwalawa, imwani mapiritsi a 1-2 patsiku, pakatha masiku 15 mutha kuwonjezera mankhwalawa mpaka zidutswa 4 patsiku | 162 |
Thimang
Amadziwikanso ndi zotsatira zomwezo pakathupi monga biguanides. Kusiyana kwakukulu ndikokwera mtengo komanso mndandanda wosangalatsa wazotsatira zoyipa.
Mankhwala okwera mtengo komanso ogwira mtima a shuga
Izi zikuphatikiza:
| Mutu | Malamulo Ovomerezeka | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Avandia | Miyezi 1.5 yoyambirira kumwa chidutswa chimodzi patsiku, ndiye, ngati pakufunika, mlingo umakulitsidwa mapiritsi 2 patsiku | Hypersensitivity to rosiglitazone, mtima kulephera, matenda a chiwindi, galactose tsankho, pakati, kuyamwitsa | 28 | 4820 |
| Aktos | Idyani zidutswa za 0.5-1 patsiku | Matenda a mtima, osakwana zaka 18, tsankho la mankhwala, ketoacidosis, pakati | 3380 | |
| Phuli | Tengani piritsi limodzi tsiku lililonse kapena popanda chakudya. | Pioglitazone tsankho, ketoacidosis, wobala mwana | 30 | 428 |
Thiazolidinediones alibe zotsatira zabwino mankhwalawa a mtundu 1 matenda a shuga.
Mankhwala obwera mwatsopano omwe amathandizira kuwonjezera insulin ndikupanga shuga ku chiwindi.
Galvus ndiyofunikira kuti amasule shuga ku chiwindi
Mndandanda wa glyptins ogwira:
| Mutu | Buku lamalangizo | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Januvia | Imwani piritsi 1 patsiku nthawi iliyonse. | Asanafike zaka 18, tsankho pamagawo a mankhwala, kutenga pakati komanso kuyamwa, lembani matenda a shuga 1, mtima, impso ndi chiwindi | 28 | 1754 |
| Galvus | Tengani zidutswa 1-2 patsiku | 812 |
Glyptins amachititsa zotsatira zoyipa zochepa, musamathandizire kulemera, kuchepetsa shuga m'magawo popanda zovuta pa kapamba.
Januvia kuti muchepetse magazi
Alpha Inhibitors - Glucosidases
Othandizira amakono a shuga amalepheretsa kupanga enzyme yomwe imasungunula zovuta zamoto, zomwe zimachepetsa kuyamwa kwa polysaccharides. Ma Inhibitors amadziwika ndi zovuta zochepa komanso amakhala otetezeka kwa thupi.
Izi zikuphatikiza:
| Mutu | Buku lamalangizo | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Glucobay | Imwani kapu imodzi katatu pa tsiku musanadye | Matenda am'mimba ndi matumbo, kuwonongeka kwa chakudya cham'mimba, kutenga pakati, kuyamwa, osakwana zaka 18, zilonda, hernia | 30 | 712 |
| Miglitol | Kumayambiriro kwa mankhwalawa, piritsi limodzi musanadye, ngati kuli kotheka, mlingo umakulitsidwa mapiritsi 6, ogawidwa 3 waukulu | 846 |
Mankhwala omwe ali pamwambawa atha kumwa mankhwala osakanikirana ndi mankhwala a magulu ena ndi insulin.
Sodium - glucose cocransporter zoletsa
M'badwo waposachedwa wa mankhwala omwe amachepetsa shuga m'magazi. Mankhwala a gululi amachititsa impso kuti zimveke shuga ndi mkodzo panthawi yomwe kuchuluka kwa shuga m'magazi kumayambira 6 mpaka 8 mmol / l.
Chida chofunikira chochepetsera shuga
Mndandanda wa Glyphlosins Wothandiza:
| Dzinalo | Njira yolandirira | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Forsyga | Imwani 1 patsiku | Matenda a mtima, kulowetsedwa kwa myocardial, kuledzera, mtundu 1 shuga, pakati, kuyamwa, metabolic acidosis, tsankho | 30 | 3625 |
| Jardins | Imwani piritsi limodzi tsiku lililonse. Ngati ndi kotheka, mlingo ukuwonjezeka 2 zidutswa | 2690 |
Mankhwala osakanikirana
Mankhwala omwe amaphatikizapo metformin ndi glyptins. Mndandanda wazinthu zophatikizika bwino kwambiri:
| Dzinalo | Njira yolandirira | Contraindication | Kuchuluka, zidutswa | Mtengo, ma ruble |
| Janumet | Tengani mapiritsi awiri tsiku lililonse ndi chakudya | Mimba, yoyamwitsa, mtundu 1 shuga, matenda aimpso, uchidakwa, tsankho | 56 | 2920 |
| Galvus Met | 30 | 1512 |
Osamwa mankhwala osakanikirana mosafunikira - yesetsani kukonda mitundu yayikulu yakanthawi yayitali.
Kuphatikiza kwa matenda ashuga
Insulin kapena mapiritsi - ndibwino kwa matenda ashuga?
Mankhwalawa amtundu wa shuga 1 a matenda a shuga, insulin imagwiritsidwa ntchito, mankhwalawa amtundu wa 2 a mawonekedwe osavuta amachokera pakumwa mankhwala kuti achulukitse shuga.
Ubwino wa mapiritsi poyerekeza ndi jakisoni:
- kugwiritsa ntchito mosavuta komanso posungira,
- kusapeza bwino pakalandilidwa,
- kuyang'anira kwachilengedwe kwachilengedwe.
Ubwino wa jakisoni wa insulin ndi njira yothanirana mwachangu komanso kuthekera kosankha mtundu wabwino kwambiri wa insulin kwa wodwala.
Jakisoni wa insulin amagwiritsidwa ntchito ndi odwala omwe ali ndi mtundu wa 2 shuga mellitus ngati mankhwala osokoneza bongo sawapereka bwino ndipo atatha kudya glucose amakwera mpaka 9 mmol / L.
Jakisoni wa insulin amangogwira pokhapokha mapiritsi atha kuthandizira
Kuphatikiza kwa zakudya zama carb ochepa komanso masewera olimbitsa thupi kumathandizira kukhazikika kwa shuga m'magazi a 2 a shuga.
Pakakhala zovuta, perekani zomwe zimakonda ndi mankhwala omwe amaphatikiza metformin - amalimbitsa shuga wambiri ndi zovuta zina. Mlingo komanso kuchuluka kwa jakisoni wa insulin kwa matenda amtundu wa 1 amawerengedwa ndi adokotala, kutengera mawonekedwe a wodwala.
Kupenda
(2 pafupifupi 5,00 pa 5)
Mankhwala a insulin
Msika wamakono wamankhwala uli ndi mitundu yonse ya mankhwala ochepetsa shuga. Koma akatswiri amaganiza kuti ngati zakudya zolimbitsa thupi komanso kuchuluka kwa mankhwala ochepetsa shuga sizingabweretse zotsatira zomwe zikuyembekezeka ndipo glycemia sichizirala, ndikofunikira kuyambitsa insulin.
Kuphatikiza ndi magulu omwe afotokozeredwa pamwambapa a mankhwala am'badwo watsopano, ma insulini amalola kuwongolera kwathunthu pamagazi a shuga odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Osamachita mankhwala a insulin ngati, pazifukwa zilizonse, opaleshoni ikuwonetsedwa kwa odwala matenda ashuga.
Ma insulin amakono - ma insulin aafupi (maola 6-8):
- Insuman Rapid,
- Humulin Wokhazikika,
- Actrapid NM.
Ultrashort insulin (maola 3-4):
Kutalika kwapakatikati kosungira (maora 12-16):
- Protafan NM,
- Humulin NPH,
- Insuman basal.
Zophatikiza zochita zake:
- Humulin MZ,
- Kusakaniza kwa Humalog,
- Mikstard NM,
- Insuman Comb.
Therapy yokhala ndi mulingo wabwinobwino wa shuga imasankhidwa kwa wodwala aliyense payekhapayekha, poganizira chiopsezo cha zotsatira zoyipa komanso kuzindikira kwa thupi la gulu linalake la mankhwala.
Mtundu wachiwiri wa matenda a shuga ukapezeka, Metformin ndi omwe amakayikira. Ngati sizotheka kukwaniritsa glycemia, mankhwala atsopano a gulu lomwelo kapena mankhwala ophatikiza amasankhidwa.
Samalirani thanzi lanu!
Mankhwala osokoneza bongo a 2 shuga
Ngati shuga akupezeka m'magazi ndikupeza matenda okhumudwitsa - shuga, chinthu choyamba kuchita ndikusintha kwambiri moyo wanu. Pamafunika pulogalamu yochepetsera kunenepa, kuwonjezera zolimbitsa thupi.
Ndi njira iyi yomwe chithandizo chitha kukwaniritsidwa. Koma cholinga chachikulu ndikuchepetsa shuga m'thupi kwa nthawi yayitali, komabe ndikofunikira kuti musankhe mankhwala.
Mwachilengedwe, palibe pulogalamu yantchito yonse yamankhwala;
Chachikulu ndikukhazikika bwino, kufunafuna kuti muchepetse hemoglobin komanso zovuta zake, kuchepetsa chiopsezo chokhala ndi mavuto onse, osayiwala za zovuta. M'pofunikanso kulola kulekerera mtima kwa mankhwalawo komanso mtengo wa chithandizo.
Akatswiri amati chinthu choyamba chomwe dokotala yemwe wapeza ndi matenda ashuga ayenera kuchita ndi kupereka Metformin kwa wodwala. Ili ndi gawo loyamba la mankhwala (ngati palibe contraindication). Mankhwalawa azitha kukhala ndi phindu lambiri m'magawo a shuga, amathandizira kuchepa thupi, komanso ali ndi mndandanda wocheperako wazotsatira (chinthu chofunikira!) Ndi mtengo wotsika.
Mankhwala ochizira matenda ashuga
Matenda a shuga ndi matenda oopsa omwe amafunikira kuwunikidwa pafupipafupi ndi adokotala. Kupereka mankhwala osokoneza bongo ndi vuto lalikulu. Dokotala wabwino amayenera kupereka yankho lolondola la matenda ashuga ndikusankha njira yodziwira payekha
Pulogalamu yathu ya pa intaneti imapereka mankhwala osiyanasiyana a shuga. Timapereka mitengo yotsika kwambiri yotsika mtengo ndikutsimikizira zofunikira kwambiri kwa makasitomala athu. Mwakufuna kwanu, takonza njira yakuperekera mankhwala yakuperekera mankhwala kwa anthu, motero simuyenera kuchoka kunyumba kuti mukagule mankhwala oyenera.
Ndi matenda amtundu wa 2 shuga, kapamba amasokonezeka, chiwopsezo cha minofu ya m'thupi chimayamba kuchepa. Matenda ofananawo nthawi zambiri amapezeka mwa anthu opitirira zaka 45.
Chithandizo cha matendawa chimakhala ngati mumwa mankhwala a hypoglycemic, ndipo adotolo amakupatsaninso mankhwala ena othandizira komanso masewera olimbitsa thupi. Choyamba odwala matenda ashuga ayenera kusinkhasinkhanso moyo wanu, kusintha zakudya zamagulu onse ndikuwonjezera ntchito zamagalimoto.
Zotsatira za mankhwala Forsig
Musanayambe kumwa mankhwalawa, ndikofunikira kuti muphunzire zamankhwala ndi kudziwa dokotala. Forsiga ndi mankhwala othandizira pakamwa, ntchito yake yayikulu ndikukhazikitsa kuchuluka kwa shuga ndi hypoglycemia.
Amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri. Chofunikira chachikulu ndi dapagliflozin propanediol monohydrate.
Imapezeka mu mawonekedwe a mapiritsi okhala ndi filimu.
Kutenga mapiritsi a Forsig sikulimbikitsidwa pamaso pa syndromes otsatirawa:
- tsankho limodzi la mankhwala
- lembani 1 hypoglycemia,
- matenda ashuga ketoacidosis,
- odziwika bwino mpaka kulephera kwa aimpso, kudwala kwamatenda,
- lactose kusalolera onse mu mawonekedwe pawokha, komanso kuphatikiza shuga.
- matenda am'mimba thirakiti
- mimba ndi kuyamwitsa,
- ana ochepera zaka 18,
- okalamba kuyambira zaka 75.
Musanalowetse mankhwalawa mu njira yochiritsira, funsani ndi endocrinologist za kufotokozera za thupi lanu pazinthu zomwe zaperekedwa.
Mankhwala
The yogwira mankhwala a Forsigi, dapagliflozin, ndizoletsa zamphamvu mosalekeza (Ki) - 0,55 nM yosankha mtundu wa 2 sodium glucose cotransporter (SGLT2) inhibitor, yomwe imasankhidwa bwino mu impso komanso mu minofu ina yoposa 70 ya thupi (kuphatikiza chiwindi, minofu yamatumbo, minofu ya adipose, gland ya mammary, chikhodzodzo. ndi ubongo) sichinapezeke.
SGLT2 ndiye chonyamula chachikulu mu glucose reabsorption mu aimpso tubules. Mtundu wachiwiri wa matenda a shuga a mellitus (T2DM), glucose reabsorption mu aimpso tubules ukupitilira ngakhale hyperglycemia. Dapagliflozin, yoletsa kusintha kwa impso, imachepetsa kuyambiranso mu impso tubules, zomwe zimapangitsa kuti impso zithetsedwe. Zotsatira za dapagliflozin mwa odwala omwe ali ndi matenda a shuga a 2, kuchuluka kwa glucose kudya mukatha kudya kumachepa, komanso kuchuluka kwa hemoglobin ya glycosylated kumachepetsedwa.
Mphamvu ya glucosuric (glucose excretion) imawonedwa mutatenga mlingo woyamba wa Forsigi, zotsatira zake zimapitirira kwa maola 24 otsatira ndipo zimapitiliza nthawi yonse yogwiritsa ntchito. Kuchuluka kwa shuga komwe impso zimapangidwa chifukwa cha njirayi kumadalira kuchuluka kwa kusefera kwa magazi (GFR) komanso kuchuluka kwa shuga m'magazi. Dapagliflozin yachilengedwe kupanga glucose amkati potsatira hypoglycemia sichikuphwanya. Mphamvu ya chinthu pa insulin katulutsidwe ndi kumva kwa izo sizitengera. M'maphunziro azachipatala a Forsigi, kusintha kwa β-cell kunadziwika.
Kuchuluka kwa shuga kwa impso chifukwa cha dapagliflozin kumayendera limodzi ndi kuchepa kwa zopatsa mphamvu komanso kuchepa thupi. Kuletsa kwa sodium glucose cotransport kumachitika ndi ofooka osakhazikika natriuretic ndi okodzetsa zotsatira.
Dapagliflozin ilibe gawo lililonse kwa ena omwe amayendetsa glucose omwe amayenda ndi glucose kuzinthu zotumphukira. Katunduyu akuwonetsa zochulukirapo kuposa nthawi 1,400 za SGLT2 kuposa SGLT1, yomwe ndi gawo lalikulu lamatumbo lomwe limayambitsa kuyamwa kwa shuga.
Zizindikiro zogwiritsidwa ntchito
Forsig amalembera zochizira mtundu 2 shuga.
Mankhwala angagwiritsidwe ntchito motere:
- monotherapy
- kuyamba mankhwala ophatikiza ndi metformin (ngati kuphatikiza uku ndikofunika),
- kuphatikiza pa chithandizo ndi metformin, thiazolidinediones, sulfonylurea zotumphukira (kuphatikizapo kuphatikiza ndi metformin), dipeptidyl peptidase 4 (DPP-4) zoletsa (kuphatikiza ndi metformin), kukonzekera kwa insulini (kuphatikiza ndi metformin) kuphatikiza ndi amodzi kapena awiri amkamwa mankhwala a hypoglycemic) pakakhala kusowa koyenera kwa glycemic.
Malangizo ogwiritsira ntchito Forsigi: njira ndi mlingo
Forsigu amatengedwa pakamwa. Kudya sikukhudza kuthandizira kwa mankhwalawa.
Mlingo wothandizidwa kamodzi pa tsiku, 10 mg iliyonse.
Mukamapangira mankhwala osakanikirana ndi kukonzekera kwa insulin kapena mankhwala omwe amalimbikitsa katemera wa insulin (makamaka, zotumphukira za sulfonylurea), kuchepetsedwa kwa mlingo kungafunike.
Ngati Forsiga amagwiritsidwa ntchito poyambira kuphatikiza ndi metformin, mlingo wake wa tsiku ndi tsiku ndi 500 mg mu 1 mlingo. Ndi osakwanitsa kuyang'anira glycemic, mlingo wa metformin ukuwonjezeka.
Mlingo woyambirira wa kuvuta kwambiri kwa chiwindi ndi 5 mg. Ndi kulolera bwino, ndizotheka kugwiritsa ntchito Forsigi 10 mg.
Kuyanjana kwa mankhwala osokoneza bongo
- thiazide ndi loop okodzetsa: kukulitsa mphamvu yawo yokhudza kukodzetsa magazi ndikuwonjezera mwayi wa ochepa hypotension ndi madzi am'mimba,
- insulin ndi mankhwala omwe amalimbikitsa katulutsidwe ka insulin: kukulitsa kwa hypoglycemia, kuphatikiza kumafunikira kusamala ndipo mwina, kusintha kwa mankhwalawa.
Zambiri zofananira za Forsigi zikusowa.
Ndemanga za Forsig
Malinga ndi ndemanga, Forsig ndi mankhwala othandiza omwe amagwiritsidwa ntchito pochotsa shuga m'thupi. Nthawi zina, chithandizo chamankhwala chimakuthandizani kuti musiye insulin kwathunthu. Komabe, ambiri amawona kukula kwa zovuta zoyipa, kuphatikiza pafupipafupi, kuchulukitsa kwa matenda otupa a genitourinary system, kusokonezeka kwa tulo, kuyabwa, kutentha thupi, kufupika.
Zolemba ntchito
Anthu okalamba odwala matenda ashuga nthawi zambiri amakhala ndi vuto la impso, amayenera kugwiritsa ntchito mankhwala a antihypertensive omwe amakhudza ntchito ya mbolo molingana ndi mfundo ya ACE inhibitors. Kwa okalamba, njira zomwezi zimagwiritsidwanso ntchito ngati kufooka kwa impso m'magulu ena a odwala matenda ashuga. Kwa odwala omwe ali ndi zaka zopitilira 65, mavuto a impso nthawi zina amapezeka chifukwa cha dapagliflozin. Zotsatira zoyipa zomwe zimachitika chifukwa chakufooka kwa ziwalo zophatikizika ndikuwonjezera kwa creatinine.
Timapereka kuchotsera kwa owerenga tsamba lathu!
Akatswiri sanaphunzire kugwiritsa ntchito mankhwala Forsig pa nthawi yomwe ali ndi pakati, choncho mankhwala amatsutsana ndi omwe ali ndi matenda ashuga. Chifukwa chake, mutanyamula mwana wosabadwayo, chithandizo chamankhwala choterocho chimayima. Sizikudziwika ngati zosakaniza kapena zina zowonjezera zimadutsa mkaka wa m'mawere. Chifukwa chake, chiwopsezo cha zovuta mu makanda chifukwa chogwiritsa ntchito mankhwalawa sichingadziwike. Ana aang'ono sayenera kumwa mankhwalawa.
Ngati zovuta zazing'onoting'ono ndi ntchito ya impso zikuchitika, mlingo wake suyenera kusintha. Mankhwalawa amadziwikiridwa kwa anthu omwe ali ndi hepatic ndi aimpso kulephera kwapakati komanso kovuta. Ngati chiwindi sichikuyenda bwino, mlingo wake sukusinthidwa, kusokonezeka kwakukulu kwa chiwalochi kumafuna kusamala mukamagwiritsa ntchito, mulingo wochepa wa 5 mg umayikidwa, ngati munthu angalekerere mankhwalawo mwachizolowezi, kuchuluka kwake kumachulukitsidwa mpaka 10 mg.
Bongo
Milandu yamankhwala osokoneza bongo opitilira muyeso kuchipatala sizinadziwikebe. Komabe, ngati wodwala aphwanya umboni wa dokotalayo ndikusintha mulingo woyenera, chodabwitsa kwambiri chitha kuchitika. Zizindikiro za izi:
- achina,
- kutsika kwakukulu kwa kuthamanga kwa magazi,
- kusowa kwamadzi.
Ngati zizindikiro zomwe zalembedwa zikugwiritsidwa ntchito molakwika ndi mankhwalawa, ndiye kuti muyenera kuchitapo kanthu kuti mupereke chithandizo choyambirira. Muli ndi izi:
- sangalatsa m'mimba ndi madzi ambiri ndikutsuka,
- perekani kwa anthu omwe akukhudzidwa ndi mankhwala omwe akumamwa
- pezani thandizo kwa dokotala.
Makampani amakono azamalonda amapereka mitundu iwiri ya mankhwala a Forsig:
Mankhwalawa ali ndi zonunkhira zomwezi. Mtengo wa analogues ukhoza kufikira ma ruble 5000. Forsiga ndiye chida chotsika mtengo kwambiri chotchulidwa.
Malangizo
Mankhwala Forsig adalembedwa kuti adokotala amupatse. Amatulutsidwa m'mafakitoreti kokha ndi mankhwala.
Kuletsa kuyendetsa galimoto mutamwa mankhwalawa - ayi. Koma izi ndichifukwa choti maphunziro ngati amenewa sanachitike. Palibenso chidziwitso chokhudzana ndi mankhwalawa ndi mowa ndi chikonga.
Kusintha kwina kulikonse mukamamwa mankhwalawa kuyenera kuuzidwa kwa dokotala yemwe akuthandizani.
Mankhwala a m'badwo watsopano wa Forsig posachedwapa adapezeka pamashelefu osokoneza bongo.Ngakhale ndizokwera mtengo, ndizotchuka.
Forsiga bwino amakhala ndi matenda a shuga m'magazi ndipo nthawi yayitali amasunga zotsatira.
Mankhwalawa alibe vuto lililonse. Milandu ya mankhwala osokoneza bongo kapena poizoni sichinadziwikebe. Koma ngakhale zili choncho, simungathe kudzilankhulira nokha.
Kutalika kwa maphunziridwe ake ndi kumwa kwa mankhwalawa kumatsimikiziridwa ndi dokotala yemwe amadziwa chifaniziro chachikulu cha matenda. Ngati muphwanya malangizowo, pamakhala chiopsezo chokhala ndi zotsatira zoyipa komanso mankhwala osokoneza bongo.
Ndemanga za Endocrinologists
Madokotala nthawi zambiri samatha kudziwa momwe mankhwalawo angachitire. Kuti muwone mndandanda wathunthu wa contraindication ndi zovuta, ndikofunikira kuti mukhale zaka zingapo. Zosintha paumoyo wamunthu chifukwa chakumwa zimatha kupitilira nthawi.
Mtengo wa mankhwalawa sukulola kugwiritsa ntchito kwambiri, mankhwalawo ndi oyenera pongoyimitsa Zizindikiro, samachiritsa matenda akulu mthupi, mankhwalawo sanaphunziridwe kwathunthu. Odwala nthawi zambiri amakumana ndi vuto la mkodzo.
Ndemanga Zahudwala
Mwezi woyamba kugwiritsa ntchito, kachilomboka kamaonekera, adotolo adalemba maantibayotiki. Pambuyo pa masabata awiri, thrush idayamba, pambuyo pake palibe mavuto, koma mlingo unayenera kuchepetsedwa. M'mawa, kunjenjemera kumachitika chifukwa cha shuga m'magazi. Sindikucheperachepera, ndinayamba kumwa mankhwala miyezi 3 yapitayo. Ndikupanga zotsatira zoyipa, ndikufuna kupitiliza chithandizo.
Amayi ali ndi mtundu wovuta wa matenda ashuga, tsopano amagwiritsa ntchito insulin tsiku ndi tsiku, amapita kwa dokotala wa macho pafupipafupi, akuchita opaleshoni yachiwiri, mawonekedwe ake akupitilirabe. Ndili ndi mantha kuti izi zindipitilira .. Pazaka zanga, ndimayamba kufooka, nthawi zina ndimamva chizungulire, ndipo malaise amayamba. Kusanthula kunawonetsa kuchuluka kwa shuga mpaka 15 mmol / L. Dotolo adakhazikitsa Forsig ndi zakudya, tsopano ndimapita kukamuwona.
Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.
Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu
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Digestin: malangizo ogwiritsira ntchito
Pharmacodynamics Mankhwalawa ndi kuphatikiza kwama michere enanso omwenso amathandizira pakuwonongeka kwa mafuta, mapuloteni, CHIKWANGWANI NDI Mafuta. Papain ndi enzyme wochokera ku kalasi yama hydrolases. Kupezeka kuchokera ku msuzi wa mtengo wa vwende. ... -
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